CPT question

sdunaway1

Guru
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120
Location
Hayden, ID
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Hello,

Our provider performed an - L4-L5 decompressive laminectomy, posterior lumbar interbody and posterolateral fusion days prior to a removal of a sutured hemovac drain.

We billed the normal code set for the PLIF but I am confused on what codes to use for the complication procedure.

The reason for the 2nd surgery is because when they were ready to pull the drain they noticed that it was sutured in place inadvertently so the dr had to reopen the incision to be able to remove the suture drain.

In his report he states that the inferior half of the fascial layer was removed and then the sutures approximating the paraspinous muscles were released. approximately the fourth one from the caudal area up was the one that was attached to the hemovac drain passing through one of the perforations in the drain itself. once this was cut,the drain was able to be puled and removed.

I am feeling like the cpt should be a 22830-78-52

this is a commercial payer- not medicare.

any help would be greatly appreciated.

Thank you
 

CodingKing

True Blue
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3,955
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1
If the return to the OR was due to a mistake by the surgeon, i'm not sure you can bill it. If it didnt require a return to the OR its automatically bundled regardles if it was a true complication.
 

sdunaway1

Guru
Messages
120
Location
Hayden, ID
Best answers
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Thank you for your response, with further research I agree with you and will not be billing this charge due to an error w the sutures.

Thank you
 
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